A 47-year-old man with eruptions on his trunk

Area of Science:

• Dermatology and Endocrinology
• Cardiovascular Medicine

Background:

• The case involves a 47-year-old male with a history of type 2 diabetes mellitus, hypertension, coronary artery disease, and hyperlipidemia.
• The patient presented with chest pain and numerous skin lesions that appeared after discontinuing cholesterol medication due to insurance issues.

Observation:

• The patient had numerous, painless, nonpruritic yellow papules on his buttocks, abdomen, back, and extremities.
• These lesions had been present for approximately 5 months and recurred after a previous discontinuation of cholesterol medication.

Findings:

• The clinical presentation of multiple yellow papules in a patient with hyperlipidemia, particularly upon cessation of lipid-lowering therapy, is highly suggestive of eruptive xanthomas.
• The patient's history of cardiovascular disease and family history of premature myocardial infarction underscore the significance of managing hyperlipidemia.

Implications:

• This case highlights the importance of consistent management of hyperlipidemia to prevent cutaneous manifestations like eruptive xanthomas.
• Prompt diagnosis and appropriate laboratory testing are crucial for managing underlying metabolic derangements and preventing cardiovascular events.